"Blessed with early onset Altzheimers, my step by step for uncut enamel as in Maryland Bridge bonding is therefore: 1. Clean uncut enamel with alcohol; 2. Dry, Dry, Dry the alcohol with 5-10 seconds with syringe about 2 inches from prep; 3. Dab on Simplicity 1 on enamel and wings of temporary maryland bridge, wait 20 seconds; 4. Gently blow air about 2 sec from about 5 inches away to evenly disperse (not dry) the sim 1; 5. brush on the sim 2; 6. Gently blow excess sim2 about 2 seconds then light cure 20 seconds; 7. Place a brushful of sim2 on the enamel and the metal wings and do NOT cure 8. Place thin film of cement on wing of metal; 9. Press firmly to position; 10. Light cure multiple times from edges of metal (about 40 total for each wing)"

1. SANDBLAST the enamel! Rinse it and DRY for 10 seconds.
2. Apply Simplicity as usual to enamel and light-cure
3. Apply another coat of Sim 2, dry, but DO NOT light-cure
4. Apply a coat of Sim 2 to metal, dry and light-cure
5. Apply another coat of Sim 2 to metal, dry but DO NOT light-cure
6. Add self-cure or dual-cure cement and seat. _________________"You need me on that wall."

I tried this technique to recement a Maryland bridge. The only step I didn't do is sandblast. She came back a few days later with the bridge off. Most of the cement stayed on the tooth but some was on the bridge. Before this effort, it stayed on for six months with Rely X. This bridge is a chronic problem and I've made it twice and done a night guard for her too. Any suggestions?

I tried this technique to recement a Maryland bridge. The only step I didn't do is sandblast. She came back a few days later with the bridge off. Most of the cement stayed on the tooth but some was on the bridge. Before this effort, it stayed on for six months with Rely X. This bridge is a chronic problem and I've made it twice and done a night guard for her too. Any suggestions?

Lawrie

Sandblasting is critical for this metal. Beyond that, I think one must consider full coverage._________________"You need me on that wall."

I read an article advising to cut small grooves into the incisal/occlusal portion of the metal wings. the result should look like a webbed foot, the cement flows sligthly between these grooves and increases retention. I have tried it a couple of times and it work pretty well. Just use a chamfer shaped diamond and direct it parallel to the wing at a 45 degree angle upwards and this will create a nice groove. remember to sanblast the groove and polish it once it is cemented.

I tried this technique to recement a Maryland bridge. The only step I didn't do is sandblast. She came back a few days later with the bridge off. Most of the cement stayed on the tooth but some was on the bridge. Before this effort, it stayed on for six months with Rely X. This bridge is a chronic problem and I've made it twice and done a night guard for her too. Any suggestions?

Lawrie

Sandblasting is critical for this metal. Beyond that, I think one must consider full coverage.

John,

I always sandbast the metal. What I was referring to was not sandblasting the enamel as in the first step of your instruction. I'll try the grooves next time. I've got two patients with recurrent debonding. Neither wants an implant and the abuttment teeth have no restorations so I'm reluctant to recomment a full coverage bridge.

1. SANDBLAST the enamel! Rinse it and DRY for 10 seconds.
2. Apply Simplicity as usual to enamel and light-cure
3. Apply another coat of Sim 2, dry, but DO NOT light-cure
4. Apply a coat of Sim 2 to metal, dry and light-cure
5. Apply another coat of Sim 2 to metal, dry but DO NOT light-cure
6. Add self-cure or dual-cure cement and seat.

I have a maryland bridge delivery this morning. In my tool kit, I have Panavia, Nexxus and Variolink II.

I had planned on Panavia. Given my options, is that the best choice? Are there any technique modifications required for the Simplicity + Panavia combo?[/b]